Active NPI
Jennifer Lynn Gray, PHD
- Psychologist
- Federal Way, WA
National Provider Identifier
1255460101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LH00007382
- Practice address
- 31620 23Rd Avenue South
Suite 318
Federal Way, WA 98003 - Phone
- (253) 653-0168
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LH00007382 | WA | Primary |
Addresses
Primary practice location
31620 23Rd Avenue South
Suite 318
Federal Way, WA 98003
Mailing address
31620 23Rd Avenue South
Suite 318
Federal Way, WA 98003
Phone (253) 653-0168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00007382 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255460101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31620 23RD AVENUE SOUTH",
"address_2": "SUITE 318",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "98003",
"telephone_number": "253-653-0168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31620 23RD AVENUE SOUTH",
"address_2": "SUITE 318",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "98003",
"telephone_number": "253-653-0168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "LH00007382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.